O'Dell M W, Hubert H B, Lubeck D P, O'Driscoll P
Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, Ohio, USA.
AIDS. 1996 Jun;10(6):667-73.
Physical disability is one of the more important determinants of health-related quality of life in person with AIDS, although little information is available on specific physical functional deficits. The purpose of this study was to document the types, frequency, severity, and correlates of physical disability in persons with AIDS.
The design was cross-sectional with assessment of disability at the initial evaluation for the AIDS Time-Oriented Health Outcome Study, an observational community-based cohort of persons with AIDS.
Disability was measured by the HIV Health Assessment Questionnaire, a self-administered assessment of perceived difficulty in eight functional categories. Additional medical and demographic information was obtained from chart review, in addition to other standardized quality of life measures.
The sample consisted of 546 persons, primarily white homosexual men, evaluated a mean of 475 days (SD, 474) after an AIDS-defining diagnosis. Ten to 50% of men reported some degree of activity-specific disability, mostly mild or moderate. Disability scores varied widely and tended to be most severe among those items considered to be high level 'instrumental activities of daily living'. Univariate correlations were strong between disability and number of symptoms, global health status, and the Medical Outcomes Study HIV fatigue index (r = -0.4223 to 0.5115 for men). Correlations between disability and either time from AIDS diagnosis or CD4 T-lymphocyte count were not statistically significant. For men, stepwise multiple regression showed that 26.9% of disability variance was explained by symptoms, 3.7% by the Medical Outcomes Study HIV fatigue index, and 1.8% by total number of opportunistic infections.
We conclude that physical function is variable among persons with AIDS living in the community, with a substantial number experiencing mild to moderate deficits tending to occur in instrumental activities of daily living. Further studies should address the need for and efficacy of appropriate rehabilitation interventions in persons with AIDS experiencing physical disability.
身体残疾是艾滋病患者健康相关生活质量的重要决定因素之一，尽管关于特定身体功能缺陷的信息很少。本研究的目的是记录艾滋病患者身体残疾的类型、频率、严重程度及其相关因素。
本研究为横断面研究，在艾滋病时间导向健康结局研究的初始评估中对残疾情况进行评估，该研究是一个基于社区的艾滋病患者观察性队列。
通过HIV健康评估问卷测量残疾情况，这是一种自我管理的评估，用于评估八个功能类别的感知困难程度。除了其他标准化生活质量测量指标外，还通过病历审查获取了额外的医学和人口统计学信息。
样本包括546人，主要是白人同性恋男性，在确诊艾滋病后平均475天（标准差474）接受评估。10%至50%的男性报告有某种程度的特定活动残疾，大多为轻度或中度。残疾评分差异很大，在那些被认为是高水平“日常生活工具性活动”的项目中往往最为严重。残疾与症状数量、整体健康状况以及医学结局研究HIV疲劳指数之间的单变量相关性很强（男性r=-0.4223至0.5115）。残疾与自艾滋病诊断以来的时间或CD4 T淋巴细胞计数之间的相关性无统计学意义。对于男性，逐步多元回归显示，26.9%的残疾差异由症状解释，3.7%由医学结局研究HIV疲劳指数解释，1.8%由机会性感染总数解释。
我们得出结论，社区中艾滋病患者的身体功能各不相同，相当一部分人在日常生活工具性活动中存在轻度至中度缺陷。进一步的研究应探讨对身体残疾的艾滋病患者进行适当康复干预的必要性和效果。
